Pyonephrosis complicated with pleural empyema – case report

Abstract

Pyonephrosis is defined as the infection of the dilated renal collector system, with a variety of etiological agents. The accumulation of pus may cause the destruction of renal parenchyma, leading to renal insufficiency. The symptoms may occur early or late in the disease’s progress and can be of a great variability. We present a case report of a 53-year-old female which suffered of low back pain, fever and nausea. The ultrasound and CT examination revealed 4th stage pyonephrosis caused by stone obstruction. It was also observed right encysted pleural empyema and pericardial fluid as pyonephrosis’ complications. The first part of the treatment consisted of inserting a percutaneous nephrostomy (PCN) probe along with the administration of antibiotics for the next two months, followed by radical right nephrectomy in renal insufficiency context. The postoperative evolution was favorable with no repercussions.